Permit BUILDING PERMIT
ITY OF TIGARD PERMIT #: BUP2004 -00134
F ,JI��, DEVELOPMENT SERVICES DATE ISSUED: 3/25/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S12600-00300
SITE ADDRESS: 09718 SW WASHINGTON SQUARE RD F -5
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE:
Remarks: Demolition of interior space in preparation for TI.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC SCHMIDT ELECTRIC INC
BY THE MACERICH COMPANY 2830 GRAND BLVD
9585 SW WASHINGTON SQ. RD. SPOKANE, WA 99203
PORTLAND, OR 97223
Phone:
Phone: 509 - 456 -2074
Reg #: LIC 149970
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 3/25/04 $62.50
[TAX] 8% State Surchart 3/25/04 $5.00
Total $67.50
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved- plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -00 I • ■ . OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
callin. 03) 246 -6699 o - 800 - 332 -2344.
Issue • By: / , A / t .i . , ,
Permittee d al
Signature: gm. c•—^-7
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
r , . REC V ED
Building Peir>nif Application c 3 2004 FOR OFFICE USE ONLY
City of Tigard ��� TIGA Date/By. dr a.5 Q Permit No . • .-66/3e/ Received 0
13125 SW Hall Blvd., Tigard, OR 97223 0�
CITY ���� Plan Review
Phone 503.639.4171 Fax: 503.598 1960 IL DI'J / '�'Fi' T J l'I Date/By. Other Permit
Inspection Line: 503 639 4175 gU e'I Date Ready/By runs El See Attached Checklist for
Internet. www ci.tigard or us Notified/Method Supplemental Information
bki 4 '' D00
- - • TYP ': WORK `' - ` : '. -.: „ REQUIRED DATA:'1=iAND 2- FAMILY, DWELLING
❑ New construction '0 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ! A . . equipment, materials, labor, overhead, and the profit for the
' CATEGORY OF CONSTRUCTION', -2 ` '•` : , -,=''.- work indicated on this application.
❑ 1- and 2- family dwelling ❑ Commercial /industrial
Valuation: $
❑ Accessory building ❑ Multi -family Number of bedrooms:
❑ Master builder ❑ Other. Number of bathrooms:
' JOB SITE INFORMATION, AND LOCATION Total number of floors:
—Job site address: #,-'4F-1/ 7 / g HA ja@a4i� c P.I New dwelling area: square feet
—City/State/ZIP: T A ,eV _ DBE Co Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: N u or) Covered porch area: square feet
Cross street/directions to job site: Deck area square feet
Other structure area: square feet
REQUIRED DATA COMMERCIAL= USECHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, matenals, labor, overhead, and the profit for the
- _ DESCRIPTION OF WORK work indicated on this application.
T Valuation: $ A'
wl'n
Existing building area square feet
New building area. square feet
®' PROPERTY - OWNER • '' ' , - ' - - 0-TENANT Number of stones:
Name: "7 �i u°Gee-4 •,... y Type of construction.
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( )
New
. ®: APPLICANT, ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/ State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone. ( ) Fax:: ( )
E -mail:
- e CONTRACTOR. ' - .. __ . gip/
Business name: S,1 kI / ./]` , /e�.LCL
.3, n5,4. . fin c H Rt9� ` T - +
. , - - - e : ;,- tB UILDING:PERMIT FEE
: -: Address: Z 83p S �ie' g iArd
'•' Please refer to fee schedule.
City/ State/ZIP• 5' "o 0.,.e !�"A•_ 99.2a3
Phone. (,Scq) l/ 2- 7 Y Fax: (,S ) g� o Fees due upon application
y Amount received
CCB lic.: / Y q 7 4 a0
Date received.
Authorized signature .. This permit application expires if a permit is not obtained
� � - within 180 days after it has been accepted as complete.
Print name /I Dw HOW Date: 5%24_0 i * Fee methodology set y Tn -County Building Industry
Service Board / r�
I \Butldm rn
g\Peuts\BUP- PemutApp doc 12/03 440- 4613T(11 /02 /COM/WEB) / n 7.
•
Building Division
Plan Submittal Requirement Matrix
�=--• Commercial & Multi- Family - New, Additions or Alterations
City of Tigard
Type of Submittal # of Plans
(Includes new, additions, and alterations.) Required at
• Submittal .
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished) •
•
Site Work 2
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 1*
Fire Protection System 3**
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue)
* For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
i:\Building\Forms \COM- PlanSubReq doc 12/24/03